<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('药品名')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-medicine_name" class="form-control" name="row[medicine_name]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-pid" class="control-label col-xs-12 col-sm-2">{:__('单位')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select id="c-pid" data-rule="required" class="form-control selectpicker" name="row[unit]">
                <option data-type="type" value="瓶"  selected >瓶</option>
                <option data-type="type" value="支"  >支</option>
                <option data-type="type" value="个"  >个</option>
                <option data-type="type" value="粒"  >粒</option>
                <option data-type="type" value="片"  >片</option>
                <option data-type="type" value="包"  >包</option>
                <option data-type="type" value="袋"  >袋</option>
            </select>
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('规格型号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-specification" class="form-control" name="row[specification]" type="text" value="">
        </div>
    </div>


    <div class="form-group">
        <label for="c-pid" class="control-label col-xs-12 col-sm-2">{:__('供应商')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select id="c-pid1" data-rule="required" class="form-control selectpicker" name="row[supplier_name]">
                {foreach name="supplier" item="vo"}
                <option data-type="type" value="{$vo.name}">{$vo.name}</option>
                {/foreach}
            </select>
        </div>
    </div>


    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('药品型号')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-model_number" class="form-control" name="row[model_number]" type="text" value="">
        </div>
    </div>

    <div class="form-group">
        <label for="c-pid" class="control-label col-xs-12 col-sm-2">{:__('药品分类')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select id="c-pids" data-rule="required" class="form-control selectpicker" name="row[type]">
                <option data-type="type" value="药品"  selected >药品</option>
                <option data-type="type" value="耗材"  >耗材</option>
                <option data-type="type" value="保健品"  >保健品</option>
            </select>
        </div>
    </div>


    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('备注')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea data-rule="required" name="row[msg]" rows="10" cols="67"></textarea>
        </div>
    </div>


    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>